Showing posts with label protocols. Show all posts

Friday, May 26, 2023

All About Ice Packs for The School Nurse

Ice, Ice Baby

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Hopefully Helpful School Nurse Tip: Believe it or not the topic of ice packs is one of the most talked about topics within The School Nurse Fb groups! My best advice is for you to have a consistent routine that works best with your school nurse office and your students. Let's explore some popular opinions on ice!

Can I have an ice pack?

It's important to remember that students will come to your office and request an ice pack for a variety of reasons. Some of these reasons require ice, some do not. As the school nurse, use the information gathered during your assessment to decide whether or not an ice pack is needed. Then start writing down these complaints in your "Common Complaints" journal. You think you'll remember, but you won't and you'll have this journal as a a great reminder!

Ice Protocol

Every school nurse's office should have protocols to follow for certain situations; even when and how to use ice packs. There might be exceptions to protocols at times, but remember to be consistent- this will help your students know what their options and expectations are when they come to your office.

Use of ice
Effects of ice: Decreases circulation, metabolic activity, and inflammation and numbs the skin.
Benefits of ice: Decreases pain, swelling, inflammation, and muscle spasm/cramping. Best used after exercise or after pain-producing activity.
Risks of ice: Prolonged use can cause frostbite.
Methods for applying cold therapy: Ice packs, ice bath/ice whirlpool, ice massage. (See “Options for applying ice.”)
When not to use ice
Immediately before physical activity
If area of icing is numb
When the pain or swelling involves a nerve (such as the ulnar nerve or “funny bone”)
If the athlete has sympathetic dysfunction (an abnormality of nerves that control blood flow and sweat gland activity)
If the athlete has vascular disease (such as poor circulation due to blood loss, blood vessel injury, compartment syndrome, vasculitis, blood clots, or Raynaud disease)
If there is skin compromise (such as an open wound; a wound that has not healed; skin that is stretched, blistered, burned, or thin)
If the athlete has cold hypersensitivity, including cold-induced urticaria (hives from cold)
How long to use ice
Two to 3 times per day (minimum); up to once per hour.
Duration varies with technique; usually 20 to 30 minutes per session. (See “Options for applying ice.”)
Ice may continue to be useful in treatment as long as there is pain, swelling, inflammation, or spasm. There is no need to switch to heat after 48 hours or alternate between ice and heat.

Resource: AAP Healthy Children

Ice Pack Options

There are a variety of ice pack options to fit the budget of any school nurse. What option is best for your office? Here are a few things to consider:

What age range are your students?
Are students allowed to only use ice packs in your office?
Can students take ice packs back to class with them?
Do you expect students to return ice packs?
Will your ice packs be single use only?
Will you or your student call/notify home every time they use an ice pack?
Can students who are "hot" request an ice pack to help them cool off?
Is eating the ice allowed?
Do you have the assessment skills & confidence to say "No" to the request for an ice pack?

Depending on how you answered these questions, will depend on what ice packs are best for your office. For my office, we prefer a countertop ice maker with single use ice packs. In fact THIS is the exact countertop ice maker we have. and it works great.

We make ice and add to gallon size bags. Then, we fill sandwich size bags about 1/2 full and keep those stocked in the freezer to use as needed & repeat the 'ice cyle' (see what I did there) as needed too!

Are countertop ice makers worth all of the pennies?

This poll is from the public Fb group for school nurses HERE.

Request to join by answering all of the membership questions.

Over the years, I've learned there are many creative ways to make ice packs. Here are a few options:

Reusable ice packs wrapped in a dry paper towel.
Frozen paper towel in a bag wrapped with a dry paper towel.
Frozen sponge inside a bag and wrapped with a dry paper towel.

What do you use?

I have this as a magnet on my work freezer!

Check out these other popular DOASN blog posts & product links.

Tuesday, June 21, 2022

The School Nurse and Student Health Screenings

Health Screenings in the School Setting

Understanding Mandatory Health Screenings vs. State-Required Health Forms: What Every School Nurse Should Know

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Helpful School Nurse Tip: As a school nurse, understanding health requirements is key to keeping your students healthy and ready to learn. But did you know that mandatory health screenings and state-required health forms serve different purposes and both are essential?

What’s the Difference?
Mandatory health screenings are designed to catch potential health issues early (like vision or hearing problems) that could affect a student’s ability to learn and thrive. These screenings focus on early detection and timely intervention.

On the other hand, state-required health forms—such as physical exams, immunization records, and medication authorizations—are linked to school attendance regulations. They ensure that students meet public health guidelines, helping to protect the entire school community.

Since requirements vary by state, it’s important for school nurses to stay informed about the specific mandates for their students. This knowledge not only helps maintain compliance but also supports the overall health and success of every child.

Communication Is Key
Effectively communicating with families about these screenings and forms is vital. Clear, compassionate conversations help parents understand why these requirements matter and encourage timely completion. Plus, building trust through consistent messaging can make a big difference in student health outcomes.

Where to Find Information
There isn’t one universal resource that covers every state’s specific mandates. However, a good place to start is the National Association of School Nurses (NASN) or each state’s Department of Education or Health Department website.

If so, look at the Department of Public Health site for your state, then search for something general such as "school health requirements"; these search results will hopefully lead you in the right direction. Or send a message or search the site of your state's school nurse consultant- search the list HERE!

Examples of Common Health Screenings in Schools:

Vision Screenings
Hearing Screenings
Scoliosis Screenings
Dental Screenings
Mental Health & Behavioral Screenings
Hunger Screenings
BMI Screenings
Lead Exposure Screenings

School nurses are uniquely positioned to provide these screenings and make referrals for follow-up care, especially considering that about 40% of children attending school have chronic health conditions (CDC, 2019).

Illinois Student Health Screening Requirements

For example, in Illinois:

Vision Screenings
"Vision screening must be provided annually for preschool children 3 years of age or older in any public or private educational program or licensed child care facility, and for school age children in kindergarten, second and eighth grades; are in special education class; have been referred by a teacher; or are transfer students." IDPH, 06/21/2022
Hearing Screenings

"Hearing screening must be provided annually for preschool children 3 years of age or older in any public or private educational program or licensed child care facility, and for all school age children grades kindergarten, first, second and third; are in special education class; have been referred by a teacher; or are transfer students. These screening services shall be provided in all public, private, and parochial schools." IDPH, 06/21/2022

If you’re a school nurse outside Illinois, I’d love to hear what your state requires! Feel free to share in the comments or reach out for support.

Staying Organized
Tracking compliance can feel overwhelming, but having a plan makes a big difference. I use a combination of digital tools like Skyward and simple paper filing systems to keep everything accessible. Find what works for you and keep refining it.

Check out the image below for examples of vision and hearing screening forms I use in my practice.

Student Health Screenings

Facebook Conversations for School Nurses by School Nurses

+ click pictures to be redirected to Fb conversations +

RESOURCES

Pure Med Central-

Missed opportunities: Do states require screening of children for health conditions that interfere with learning?

New to School Nursing?

If you're just beginning your school nursing journey, keeping track of state health requirements, screenings, immunizations, and health forms can feel overwhelming.

That's exactly why I created Ten Hot Topics for New School Nurses.

This practical guide highlights ten important topics every new school nurse should explore during their first year, along with thoughtful questions to ask during orientation and direct links to helpful Diary of a School Nurse blog posts for deeper learning.

Rather than trying to learn everything at once, you'll have a roadmap to help you build confidence one topic at a time.

✔️ School-specific questions to ask

✔️ District and state health requirements

✔️ Organization tips

✔️ Professional growth resources

✔️ Direct links to additional blog posts and helpful references

If you're looking for a simple place to start, this guide was created just for you.

👉 Learn More About the Ten Hot Topics Guide

Check out these other popular DOASN blog posts & links.

School Nurse Office Visits? Routines, Passes, and a Little Bit of Calendly Magic

Student Office Visits to the Nurse's Office

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One thing you can count on as a school nurse- students will show up at your door! That daily routine is a big part of the job.

But how they get to your office? That’s where boundaries come in. Setting a few simple expectations helps keep things running smoothly and makes sure everyone gets what they need (including you).

Hopefully Helpful School Nurse Tip: If you know me, you know I don’t love change. However, if you work with me, then you know I’m always changing things! Don’t be afraid of change—be willing to try new things. Something might work better than you expected.

I don't like change yet I'm always changing.

How Do Students Visit The Nurse's Office

The majority of a school nurse’s day revolves around meeting students’ health needs. One of the first systems you’ll need to establish is how students are expected to visit your office. Over the years, I’ve tried many different approaches to manage office traffic and support student access to care.

Here are the main methods we use in my office:

Ways Students Visit the Nurse’s Office

Teacher pass – This is the most common method and works well for non-urgent needs. (sample passes here)
Walk-in – Students may walk in if it’s an open time or they have urgent needs.
Phone call or email from teacher – Staff may call to see if space/time is available, but I've received emails from students too!
Scheduled appointment – Yes, we actually allow students to book a nurse’s appointment!

Why Appointments Work for Us

We started using Calendly during the 2021–2022 school year after noticing our school counselors were already using it. Because staff and students were familiar with it, the transition was smooth.

Scheduling appointments helps students articulate their health concerns and build independence- two skills that are essential for high schoolers.

Here are a few key Calendly points (IMO):

Key Calendly Benefits:

Free version available (we use it!)
User-friendly interface
Syncs with Google Calendar (our IT department created a dedicated Google account for this)
Flexible settings – We allow 5-minute appointments, include 5-minute buffer time, and limit scheduling to 5 days in advance.
Custom questions – Students select the reason for their visit and preferred outcome (dropdown options).
Reduces unnecessary visits – Some issues can be handled via email, keeping students in class.
Appointment prioritization – We still accept walk-ins but prioritize students with appointments.
Custom scheduling blocks – I block out time for lunch, meetings, or days off.
Data tracking – Helpful for end-of-year reports.

We’re still discovering ways to make the most of Calendly—but it’s already been a game-changer for managing visit flow.

Charting Student Visits and Medications

In addition to using Calendly and some paper charting, we use Skyward for documenting medication inventory and administration. Since the 2022–2023 school year, we’ve also been documenting basic office visits in Skyward instead of using our former Google form (another change!)

This change has improved our reporting accuracy and made our end-of-year Board of Education (BOE) report easier to compile. If you’re tracking visits and meds separately, consider combining your documentation into one system if your district allows it.

With all that said, I know some school nurses- and even teachers- use a Google Form to request nurse office visits. It’s a great option for Google-based schools, especially when it comes to tracking and triage. You can easily edit the form above to fit this type of use, too!

When Should Students Be Sent to the Nurse?

Clear communication with staff is essential to reduce unnecessary disruptions and ensure timely care. At the beginning of each semester, I email a brochure to all staff with:

A welcome message and contact info
How to view their students with chronic health conditions in Skyward
The types of services we provide (urgent, non-urgent, grab-n-go table)
School attendance guidelines
Links to staff education for managing chronic conditions (e.g., asthma, seizures, diabetes, allergies)
An invitation to stop by the nurse’s office to meet our team

The below brochure was created for use with parents, but it is editable & you could probably switch things up a bit for use with staff & students!

Whether you're new or experienced, setting clear routines for nurse office visits can help your day run smoother and ensure students get the care they need. Don’t be afraid to try something new—you might just love the change!